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ARCHIVED -
Supplement -
Canadian National Report on Immunization, 2006

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Acknowledgements

We acknowledge the continuing contribution of our immunization
program and surveillance partners, including, but not limited to,
the following groups and organizations: provincial and territorial
epidemiologists, public health and immunization experts; the
Canadian Nursing Coalition for Immunization; National Microbiology
Laboratory, Winnipeg; National Centre for Streptococcus, Edmonton;
provincial public health laboratories; members of the Immunization
Monitoring Program, ACTive; the Canadian Paediatric Society and
physicians contributing to the Canadian Paediatric Surveillance
Program; Canadian members of the International Circumpolar
Surveillance Invasive Bacterial Diseases Working Group; the
FluWatch network of sentinel physicians and the College of Family
Physicians of Canada.

Staff members of the Immunization and Respiratory Infections
Division, Centre for Infectious Disease Prevention and Control,
Public Health Agency of Canada, Ottawa, Ontario, Canada,
contributed to determining the content, writing and editing of the
report.

The artwork on the cover - an original drawing by Christian
Morin from École Dagenais in Macamic, Quebec - was selected
as the National Winner of the Canadian Immunization Poster
Competition for grade 6 students. The competition was organized by
the Immunization and Respiratory Infections Division and the
Canadian Coalition for Immunization Awareness & Promotion, in
conjunction with the sixth Canadian Immunization Conference in
December 2004. The theme was "Give Us Your Best
Shot".

Preface

Since the publication of the 1998 Canadian National Report
on Immunization, the landscape of public health in Canada has
changed considerably, foremost with the creation of the Public
Health Agency of Canada and the Pan-Canadian Public Health Network
in 2004. This was preceded by the acceptance of the National
Immunization Strategy (NIS) by the Conference of Federal,
Provincial and Territorial (F/P/T) Deputy Ministers of Health and a
commitment of $45 million over 5 years in the 2003 Federal Budget
to strengthen national collaboration on immunization. In Budget
2004, the Government of Canada provided $300 million directly to
the provinces and territories (P/T) to support the introduction of
four new childhood and adolescent vaccines.

In the context of these significant changes, the purpose of this
report is to cover progress in immunization, including current P/T
programs and the results of the National Immunization Coverage
Surveys, and to provide an update since 1998 on trends in select
vaccine-preventable diseases and in adverse events following
immunization. While major highlights of the progress of the NIS are
discussed in a feature section of this report, there have been many
milestones for immunization in the past several years that are
worth emphasizing here:

continued low disease rates for many vaccine preventable
diseases and limited spread of import related measles and rubella
cases, signalling the elimination of these diseases in Canada;

the expansion of routine immunization programs to include
childhood pneumococcal conjugate vaccine and adolescent acellular
pertussis programs in all provinces and territories, as well as
childhood meningococcal and varicella zoster vaccine programs in 12
jurisdictions;

improvements over time in vaccine coverage estimates among
2-year-olds for a single dose of the measles, mumps and rubella
vaccine and for four doses of diphtheria, pertussis, tetanus, polio
and Haemophilus influenzae type b combination
vaccines;

a dramatic decline in the reported frequency of specific
adverse events since the switch from whole-cell to acellular
pertussis vaccines in childhood immunization programs in
1997-98;

the first national consensus conference of national goals and
recommendations for vaccine preventable diseases held in June
2005;

the first national research priorities workshops on influenza
and on human papillomavirus vaccines, held in the fall of 2005, to
identify knowledge gaps and ways to address these gaps;

new collaborations forged between public health and experts in
immunization, sexually transmitted diseases, and cancer prevention
and management to design effective immunization strategies for the
newly approved human papillomavirus vaccine;

establishment of a pandemic influenza vaccine readiness
contract with our domestic supplier in 2001, the first country to
achieve this, and the Canadian Pandemic Influenza Plan, published
in 2004, to facilitate national coordination in preparedness and
response activities;

the release of the 7th edition of the Canadian Immunization
Guide in 2006;

the provision of cutting-edge information on immunization
science, policy, programs and practice and a forum for networking
and knowledge-sharing among the many disciplines working in
immunization through the biennial Canadian Immunization Conference.
The December 2006 instalment is aptly entitled, Celebrating
Immunization in Canada: Achievements and Opportunities.

Despite these achievements, however, there have been sporadic
outbreaks of measles, mumps and rubella in several jurisdictions,
which serve to remind us that Canada will experience ongoing
importations of vaccine-preventable diseases and that there are
pockets of non-immunized or under-immunized populations vulnerable
to the introduction of such infectious agents. The spread of
poliovirus to 11 previously polio-free countries in Africa and
southeast Asia during late 2004 and 2005 illustrates the necessity
for constant vigilance in immunization coverage and disease
surveillance if we are to minimize the impact of
vaccine-preventable diseases both in Canada and abroad. The
outbreak of Severe Acute Respiratory Syndrome (SARS) in 2003
highlighted the need to strengthen our public health
infrastructure, including immunization programs, and our capacity
to conduct rapid vaccine research and development for emerging
infections.

Where do we go from here? Given the current development in
vaccine technology and research, it is expected that new vaccines
will have a major impact on the delivery of immunization programs
and the epidemiology of vaccine-preventable diseases in the coming
years. A number of new vaccines are expected on the horizon, and
innovative collaborative approaches are expected to continue in the
future to facilitate vaccine program design and implementation, and
to address security of supply. It will be important to monitor our
progress closely, identify and address challenges, and report on
our accomplishments.